How to interview a patient with back pain
Other platforms explain it with text and video. In VMS you practice it on the patient.
Most back pain gets better on its own, but a few causes need urgent action. A short list of red flag questions separates them.
Step by step
Introduce yourself and get consent
Let the patient choose a comfortable position. [1]
Onset and mechanism
When it started, what they were doing, lifting, a fall or no reason at all. [2]
Location and radiation
Where it hurts and if it goes down the leg below the knee (nerve root pain), with numbness or tingling. [2]
Nerve red flags
Numbness in the groin or buttocks (saddle area), new trouble passing or holding urine or stool, and leg weakness that is getting worse: these need urgent care. [3]
Infection and cancer red flags
Fever, injection drug use, weak immune system, past cancer, weight loss without trying, and pain at night or at rest. [3]
Fracture red flags
Trauma, older age, osteoporosis and long-term steroids. [3]
Inflammatory pattern
Under 40 with morning stiffness that improves with exercise suggests an inflammatory cause. [3]
Function and plan
Work, sleep and daily activities, past episodes and treatments. Summarize and explain the next step. [1]
Common errors
- Not asking about bladder and bowel control.
- Skipping cancer and infection questions in a patient with a known risk.
- Ordering imaging for every patient without red flags.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- AAMC Core Entrustable Professional Activities (Core EPAs)
- NBOME COMLEX-USA clinical presentations
- NCCPA PANCE Content Blueprint
Facts and steps follow NBOME COMLEX-USA clinical presentations; NCCPA PANCE Content Blueprint. VMS is not affiliated with these organizations. Updated: 2026-10-11.